Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.
Hum-498 Research Team, University of Almeria, Almeria, Spain.
Ther Adv Respir Dis. 2022 Jan-Dec;16:17534666221089467. doi: 10.1177/17534666221089467.
Cystic fibrosis (CF) is an autosomal recessive disease that involves the cells that produce mucus and sweat, affecting many organs, especially the lungs. Positive expiratory pressure (PEP) devices generate a pressure opposite to that exerted by the airways during expiration, thus improving mucociliary clearance.
To evaluate the efficacy of PEP devices as a resource to facilitate the mucus removal and other outcomes in people with CF, as well as the possible adverse effects derived from their use.
A systematic review and meta-analysis was conducted according to PRISMA standards. The descriptors were 'cystic fibrosis', 'PEP', and 'physiotherapy and/or physical therapy'. The search was performed in four databases: PubMed, PEDro, and Web of Science and Scopus, in July 2021. The inclusion criteria were randomized controlled trials (RCTs) over the last 10 years. The methodological quality of the studies was analyzed and meta-analysis was performed with Review Manager software.
Ten RCTs met the objectives and criteria, with a total of 274 participants. The trials score a moderate methodological quality on the PEDro scale. No clear results were obtained on whether PEP provides better lung function than other breathing techniques (such as airway clearance); but it does achieve a higher rate of lung clearance than physical exercise.
PEP is more effective than usual care or no intervention, although there is not enough evidence to confirm that PEP achieves improvements in forced expiratory volume in the first second (FEV) compared with other techniques. It is a safe technique, without adverse effects.
囊性纤维化（CF）是一种常染色体隐性疾病，涉及产生黏液和汗液的细胞，影响许多器官，尤其是肺部。呼气正压（PEP）设备产生与气道在呼气时所施加的压力相反的压力，从而改善黏液清除。
评估 PEP 设备作为促进 CF 患者黏液清除和其他结果的资源的疗效，以及其使用可能带来的不良反应。
根据 PRISMA 标准进行系统评价和荟萃分析。描述符为“囊性纤维化”、“PEP”和“物理疗法”。检索在四个数据库进行：PubMed、PEDro 和 Web of Science 以及 Scopus，检索时间为 2021 年 7 月。纳入标准为过去 10 年的随机对照试验（RCT）。对研究的方法学质量进行分析，并使用 Review Manager 软件进行荟萃分析。
10 项 RCT 符合目标和标准，共有 274 名参与者。PEDro 量表上的试验方法学质量为中等。PEP 是否比其他呼吸技术（如气道清除）提供更好的肺功能，尚无明确结果；但它确实比体育锻炼实现了更高的肺清除率。
PEP 比常规护理或无干预更有效，尽管没有足够的证据证实 PEP 与其他技术相比能提高第一秒用力呼气量（FEV）。它是一种安全的技术，没有不良反应。
